Coastal Spine & Disc, Inc.

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CH3653 Issued in FL

Legal business name

COASTAL SPINE & DISC, INC.

Practice address

19 SE Osceola St
Stuart, FL 34994-2125

Phone

(772) 287-7701

Fax

(772) 220-4473

NPI assigned

Jan 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Randolph Hansbrough, DC

Title

Director

Phone

(772) 287-7701

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1013288679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942125",
            "telephone_number": "772-287-7701",
            "fax_number": "772-220-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942125",
            "telephone_number": "772-287-7701",
            "fax_number": "772-220-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SPINE & DISC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "HANSBROUGH",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "772-287-7701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH3653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Medical & Wellness Center, PLLC
• Coastal Optical Center Inc
• Coastal Orthopaedics & Sports Medicine Center
• Coastal Pain Solutions, Inc
• Coastal Pain Solutions, Inc.
• Coastal Urology of Stuart, PA
• Leannette Cobas
• Tara Ann Cobb, PA-C
• Robert S. Cobiella, M.D.
• Rebecca S Cobo, RBT

• Neurology Chiropractor in Stuart, FL
• Providers in Stuart, FL by specialty
• Neurology Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.